How Menstrual Health Can Impact Eating Disorders and Body Image

In this blog post, Butterfly National Helpline counsellor Lillian discusses the many links between menstrual health, eating disorders and body image issues.

It’s no shock that menstrual health is generally under-researched, and when you combine menstrual health with mental health, we have even less data. However, the link is real and significant, impacting so many people’s lives and wellbeing. The complexities of menstrual health can also impact body image and disordered eating, as well as the other way around.  

As someone passionate about menstrual health, eating disorders, and lives their life identifying as a woman, I feel dedicated to providing support and care for the complexities this can bring up. Working as a counsellor on the Butterfly Helpline, I hear and see many issues that arise for so many women and people with a uterus in Australia. Challenges include trying to navigate their experience with menstrual health, having a period, not having a period, and the complexities that come with uterine health and eating/body image. 

These complexities can be diverse and look different for each individual. Situations that come up include things like Poly-Cystic Ovarian Syndrome (PCOS) Endometriosis, Adenomyosis, Pre-Menstrual Dysphoric Disorder (PMDD), and Amenorrhea, to only name a few. These conditions have significant mental and physical implications on our health and wellbeing.  

PCOS is the most commonly experienced endocrine-metabolic disorder impacting people with a uterus across their entire life, with research depicting strong associations with body dis-satisfaction and disordered eating. Research has found that women diagnosed with PCOS engaged in disordered eating behaviours at 4 times the rate of women without PCOS.  

PCOS as well as other menstrual health issues such as PMDD, Endometriosis, etc, can have further physical complications that arise. This can include insulin resistance, weight fluctuations, uncomfortable physical sensations, debilitating pain, and bloating.  Depression, anxiety and other mental health issues can also arise, leaving people feeling vulnerable, helpless and confused.  

The relationship between eating disorders and menstrual health concerns can go both ways, as behaviours associated with eating disorders, like restriction or binge eating, affect hormone production in the body, leading to further hormonal dysfunction or imbalance.  

People often go to a health professional such as GP, dietician, naturopath, etc, to seek answers and reprieve. They are often provided with dietetic advice or told altering body weight will help manage symptoms. This is often where an onslaught of issues can arise and a slippery slope of fixation on food, exercise, and shape can take its toll, and efforts to lose weight or change our body can do more harm than good. This can contribute further to hormone imbalances and increase in disordered eating symptoms.  

Birth control and other menstrual medications also play a part in this conversation. While they can help to alleviate symptoms, providing hope and relief to many, they can also complicate things, mixing more hormones into an already multi-layered hormonal experience. Encountering the possible side effects of these medications such as bloating, pain, and nausea can be even more confusing. This can prompt people to engage in disordered eating to try and alleviate side effects and try to control body changes. The right medical support and advice is crucial to help navigate these areas.  

There is also a myriad of advice on social media platforms and online about how we can change our lifestyle/diet/routine to minimise symptoms or heal from these concerns. This can leave individuals feeling even more confused, desperate, and willing to try others’ tips and strategies that aren’t based in evidence and are sometimes unsafe, again, often doing more harm.  

People with the genetic vulnerabilities to develop a condition like PCOS or PMDD may also have other vulnerabilities associated with developing an eating disorder or body image issues, making the relationship between the two complex, and important to consider. 

Getting support 

If you are experiencing some concerns with your menstrual health, or are trying to navigate symptoms, it’s important to link in with professional supports that understand the physical conditions, as well as the risk to your mental health and any eating concerns. This could include GP’s, dieticians, and counsellors/psychologists that are across eating disorders and women’s health. This can take some trial and error, but it can make such a difference. 

 A great place to start is Butterfly’s National Referral Database, which lists a range of different health professionals who are eating disorder informed. We also recommend finding a practitioner who practices from a Health at Every Size standpoint, who can provide advice based on your needs and holistic health, and not just focus on the size of your body.  

Additionally, it is so important that health professionals and our loved ones can explore and look out for warning signs and symptoms such as pre-occupation and obsession with food/shape starting to creep in. This can help bring it to our attention and intervene early, before things get even worse. It can also help to research as much as you can about eating disorders, how they develop, are maintained, and triggers, prompting you to also see any signs early.  

Other tips include tracking your symptoms/period either in a journal or on apps such as Clue, Belle, and Glow. This can help you identify possible connections between symptoms and more clearly share your concerns with health professionals.  

We need to be cautious of the information presented on social media. However, it can be a supportive place and help you feel part of a community that shares in your experience and some advice can be helpful. Connecting with the right online community can be destigmatising and can help you feel supported and self-compassionate, so it’s something to explore if it would feel right for you. 

It is best to use critical thinking when viewing advice online – think about where the information has come from, if it’s evidence-based and applicable to your own circumstances. Quite often it won’t be, and it’s best to use information found online as a guide or starting point to discuss with your healthcare professional 

Another tip is focussing on the way your body feels rather than looks. It can help to ask yourself some questions such as; what foods make me feel energised? What foods make me feel bloated? Is there a certain time of the month that I want to prioritise movement and others where I might want to prioritise rest? Getting to know your cycle, phases, and how your body ebb and flows can help you make choices that are right for you. 

Although going through these struggles can feel hopeless and isolating at times, support is available, and more research is being conducted to better understand how to manage this area. There is hope and there are ways to heal and manage your health this space. Learning about these conditions and connecting with support can help you take one step closer towards holistic health and wellness.  

Written by Lillian, Butterfly National Helpline counsellor.

Get support

For confidential and free support for eating disorders or body dissatisfaction, connect with the Butterfly National Helpline by calling 1800 ED HOPE (1800 33 4673), or visit www.butterfly.org.au to chat online or email, 7 days a week, 8am-midnight (AEDT). 

To find healthcare professionals that are informed about eating disorders, search Butterfly’s Referral Database:  

Learn more

Access more resources and lived experience insights into women’s health, eating disorders and body image concerns in Butterfly’s campaign The Changing Room.  

References

https://www.sciencedirect.com/science/article/pii/S2161831324000279 

https://www.endofound.org/the-link-between-eating-disorders-and-endometriosis 

[3] Muhlheim, L. (2020). Eating disorders and women with PCOS. Very Well Mind. Retrieved from https://www.verywellmind.com/eating-disorders-and-pcos-4685798. 

https://www.eatingdisorderhope.com/risk-groups/eating-disorder-polycystic-ovarian-syndrome